帕瑞昔布钠超前镇痛对宫腔镜手术患者术后疼痛、炎症反应指标的影响

Effect of preemptive analgesia with parecoxib sodium on postoperative pain and inflammatory markers in patients undergoing hysteroscopic surgery

摘要:

目的 探讨帕瑞昔布钠超前镇痛对宫腔镜手术患者术后疼痛及炎症反应指标的影响。方法 选取2022年5月—2024年5月江南大学附属医院接收的92例宫腔镜手术患者为研究对象。通过随机数字表法，将患者分为对照组（常规麻醉）和观察组（帕瑞昔布钠超前镇痛），各46例。比较两组患者的疼痛及舒适度指标、炎症指标、氧化应激指标、镇静与恢复指标及不良反应发生情况。结果 观察组与对照组术后2、12和24 h的视觉模拟评分法（VAS）评分、布鲁格曼舒适度量表（BCS）评分、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、前列腺素E2（PGE2）、丙二醛（MDA）、总抗氧化状态（TAS），促肾上腺皮质激素（ACTH）水平比较，结果 ①不同时间点VAS评分、BCS评分、IL-6、TNF-α、PGE2、MDA、TAS及ACTH水平比较，差异均有统计学意义（P <0.05）。②观察组与对照组VAS评分、BCS评分、IL-6、TNF-α、PGE2、MDA、TAS及ACTH水平比较，差异均有统计学意义（P <0.05）；观察组VAS评分、IL-6、TNF-α、PGE2、MDA、ACTH水平均较低，BCS评分、TAS水平均较高。③两组VAS和BCS评分变化趋势比较，差异均无统计学意义（P >0.05）；两组IL-6、TNF-α、PGE2、MDA、TAS及ACTH水平变化趋势比较，差异均有统计学意义（P <0.05）。观察组患者Ramsay镇静评分高于对照组（P <0.05），苏醒时间和呼吸恢复时间均低于对照组（P <0.05）。观察组与对照组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 帕瑞昔布钠超前镇痛可显著减轻宫腔镜手术患者术后疼痛，降低炎症反应水平，促进术后恢复，且治疗安全，有利于临床推广应用。

Abstract:

Objective To investigate the effect of preemptive analgesia with parecoxib sodium on postoperative pain and inflammatory markers in patients undergoing hysteroscopic surgery.Methods Between May 2022 and May 2024, a total of 92 patients scheduled for hysteroscopic surgery were enrolled and randomly divided into a control group (n = 46, receiving conventional anesthesia) and an observation group (n = 46, receiving preemptive analgesia with parecoxib sodium) using a random number table. Comparisons were made between the two groups regarding pain and comfort measures, inflammatory markers, oxidative stress indicators, sedation and recovery parameters, as well as the incidence of adverse reactions.Results Comparisons of VAS scores, BCS scores, and levels of IL-6, TNF-α, PGE2, MDA, TAS, and ACTH at 2, 12, and 24 hours postoperatively in the observation and control groups demonstrated that they were different across the time points (P < 0.05) and between the groups (P < 0.05). Specifically, the observation group showed lower VAS scores, IL-6, TNF-α, PGE2, MDA, and ACTH levels, and higher BCS scores and TAS levels compared to the control group. No significant difference was found in the change trends of VAS and BCS scores between the two groups (P > 0.05), while significant differences were observed in the change trends of IL-6, TNF-α, PGE2, MDA, TAS, and ACTH levels (P < 0.05). The Ramsay sedation scores in the observation group were significantly higher than those in the control group (P < 0.05), and the observation group had shorter time to awakening and respiratory recovery (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Preemptive analgesia with parecoxib sodium significantly reduces postoperative pain, attenuates the inflammatory response, and facilitates recovery in patients undergoing hysteroscopic surgery. This strategy is safe and holds promise for broader clinical application.